Why are doctors so concervitive?

[fairnymph]

True addicts don't use to get high, they use to feel normal.

I think this is a very interesting assertion, possibly a very true one. Thank you.

 

[BilZ0r]

True addicts don't use to get high, they use to feel normal.

That sounds like rubbish to me. How can someone do something they have never done before, to feel something they have never felt? Once someone becomes addicted, as I have allready said, they have become physiologically rewired on a structural level to crave drugs, but before that, they don't. No one (well almost no one) is born or develops an overwhelming urge to do drugs. They take drugs for whatever reason, to be cool, becasue they are curious, (or in the few cases, because of misinformation by a health professional) and then they become addicted through misuse.

People with "fucked up histories" do a lot of fucked up shit but one can't dissolve oneself of blame just because of that.

 

[gloggawogga]

They take drugs for whatever reason, to be cool, becasue they are curious,

People may experiment in order to be cool or because they are curious. But when people keep taking drugs long enough to get addicted, its because they are trying to avoid some kind of pain or discomfort, which could be physical, emotional or both. You can say people are responsible for their own problems, but parents, doctors, teachers, society and overall socioeconomic conditions are also responsible for what becomes of children as they grow up. If all you can do is just stereotype addicted people as character flawed, without understanding their particular situations, you aren't helping anyone or the cause of harm reduction at all.

 

[fairnymph]

BilZ0r, I think you are misinterpreting that comment.

By the time you are truly addicted to something, being high IS your norm; therefore once you are that deeply into it, you feel you need the drug to subsist, to bring any sense of normalcy. Also, with most drugs, you lose the euphoria, or most of it, after a certain point, so it's not really possible to get 'high'.

And, depending on the drug, there may be changes in the brain , downregulation and such, that make it so that the drug is actually subbing in for a normal brain, to an extent.

 

[BilZ0r]

^ Yes, but I'm not talking about once you have become addicted. I have said three or four times in this thread, once you are addicted, you are addicited, you are physiologically wired to have a massive compulsion to take a drug. But before you get addicted, it you're own choice to misuse a drug.

But when people keep taking drugs long enough to get addicted, its because they are trying to avoid some kind of pain or discomfort

So the 500 million+ tobacco smokers worldwide all are doing it to escape?

If all you can do is just stereotype addicted people as character flawed, without understanding their particular situations, you aren't helping anyone or the cause of harm reduction at all.

I could say the same about the idea of shifting blame for drug misuse off the individual.

Everyone always has a choice. It might be the choice between two nasty options, but you always have a choice. I strongly doubt, that in this day, there are more than a handful of people, who, when they start using highly addictive drugs recreationally, aren't awear that the drug in question is addictive. It's their choice to use it once, and its their choice to use it a second time. They may have "addictive personalities/genotypes" and they may have "self-destructive tendencies" (whatever that is), and these things may be the fault of their nature/nurture, but it's still their choice to misuse a drug.

 

[gloggawogga]

So the 500 million+ tobacco smokers worldwide all are doing it to escape?

"Escape" and "character flaw" are your terminology, terminology with a judgemental connotation. I simply said people start habitually using drugs for reasons related to emotional and/or physical comfort. That includes tobacco. I started smoking cigarrettes when I was 12 years old to be cool. At the time, being cool was emotional comfort.

I could say the same about the idea of shifting blame for drug misuse off the individual.

I'm not shifting any blame. I said people were responsible for their actions. But you sill aren't accomplishing anything by simply judging people for what they do when they are 12 years old without looking at the effect that parents, schools, socioeconomic conditions, etc. are having on them.

Everyone always has a choice.

Choices are not made in a void. Choices are made under a specific set of circumstances. You show nothing but your own ignorance when you judge peoples actions as "character flawed" without understanding the circumstances they are in.

 

[BilZ0r]

Avoid, escape, It means the same to me man. They might have different connotations in your mind, but to me they are synonyms.

I don't care whether I am accomplishing anything. My point in this discussion/insult fest isn't to accomplish anything, this is arguing on the internet (ref to: special Olympics image). I think doing stupid things is a flaw in your character. Someone may be more likely to do stupid things because their parents did them, but it doesn't stop them from being any less stupid for doing them, it just means they have another reason/excuse (again synonyms).

Of course, I'm very uncomfortable in this discussion because I am at heart a determinist. These people are going to do what they do... they don't really have a choice, no one really does, but it all gets a bit boring if you start going too far down that road. But whether you are stupid because you choose to be, or stupid because you're a complicated Newton's Cradle... you're still stupid.

 

[gloggawogga]

^^^

Personally, I find people who have nothing to offer but negative and condescending stereotypes to be alot more stupid and character flawed than most people who use drugs. And I also think this forum might be a little bit more like advanced drug discussion and a little bit less like internet special olympics if the moderator here would set a mature example instead of condescendingly calling people stupid and character flawed. Of course, its the mod's choice what character and attitude he wants to set in his forum. I will admit, I've made mistakes in PD. You do what you want with this forum, man.

 

[smartshop]

I just came from a two week course on addiction and find the statements by bilzor really quite shocking. I do agree with the point made on personal responsibility, but the blaming is quite beond what i expected in an "advanced drug discussion". I have worked with addicts and found that most hard drug addicts in treatment have started at 14, how can you expect anyone that age to make informed decisions if the frontal cortex doesn't mature until 24?
As the lecturer on Motivation Interviewing mentioned when a similar discussion in our class developed: "you have the right to your personal opinion, but realize that if you blame an addict and can not empathise with his situation you should never get involved in treating them". And this also relates back to the original question. I f a doctor can not be empathetic towards addicts he should not treat them and leave it to another. I just learned that methadone treatment might not be working too well (people still use heroin on top) because the doses being prescribed are so low. Some might need as much as half a gram per day, this will probably never be implemented by normal doctors. But then again we have doctors here prescribing up to a gram of pure heroin per day so they won't mind

 

[BilZ0r]

I don't think there is anything negative or condecending about calling someone who does something stupid, stupid.

 

[smartshop]

o.k. this is not going anywhere

 

[maybetinymaybesad]

malpractice and the DEA. did anyone see that recent article in TIME magazine about the pain doctor in Montana who the DEA went after for prescribng too many opiates? he was the only good one in huge distances and a whole bunch of legitimate patients were suddenly hung and dry because of the DEA. i am sure that some of the people that got scripts from him weren't truly in need of them, and a lot probably developed tolerance/addiction.

it's seems ludicorus to me that doctors have to hold back for fear of being prosecuted, but you can't balme the doctors. thye have to work within the framework the government/our society that sues over every tiny thing has set up. the doctors who don't get screwed like this guy in montana. seriously, though, i (rightly) don't see the government restricting the amount of food obese people eat even though it's killing a lot of them, and i don't see why their attitude towards opiates isn't the same.

 

[Black Octagon]

Am I the only one who thinks this thread does not belong in ADD? I would have thought it more appropriate for TDS or somewhere like that.

 

[Donbon]

DEA is causing allot of malpracticee, their standarts are shit and not worthy to be called real standarts, they stinks nuf said

 

[paradoxcycle]

Originally posted by Black Octagon
Am I the only one who thinks this thread does not belong in ADD? I would have thought it more appropriate for TDS or somewhere like that.

I disagree. As much as I hate to say it, if we move it to another forum I think it will go downhill fast. Please keep it here; this thread is fascinating.

 

[Black Octagon]

I know it might appear interesting, but the original topic of this thread has been all but lost. What we're left with essentially are people's subjective opinions about the nature of addiction.

For the record, I'm of the opinion that addiction is an illness, and that 99% of the time is is self-inflicted. The reason people decide to do things which bring about their own addiction are immaterial when it comes to medically treating an addict's physical cravings.

But again, this is all highly abstract. Since no-one here is discussing any of the science behind addiction, this thread belongs over at places like The Dark Side, or Thought and Awareness.

And in fact, discussion of it already has begun over at TDS so there's nothing left to salvage here anymore.

 

[gloggawogga]

Addiction in itself is not disease or an illness per se. People who drink coffee/caffeine every day are addicted. Thats not considered a disease, and thats the majority of addicts in the world. Similarly, there are people who are dependent on medications, such as prozac for depression or narcotics for chronic pain. Now you can say the depression or chronic pain is a disease, but the drug dependency in those cases is just a side effect of the medication used to treat the disease. If using a drug on a daily basis helps a person function better, and the use is not compulsive, I don't see how it can be called a disease.

In some situations though addiction is a disease, like if someone is using compulsively or is using more than they need to and is unreasonably harming one's self or others by using that much. That might be the case with vast majority of younger people losing control with recreational use of opiates/opiods. But don't generalize it to all addiction, or even all addiction to opiates/opiods.

 

[Black Octagon]

Addiction in itself is not disease or an illness per se. People who drink coffee/caffeine every day are addicted. Thats not considered a disease, and thats the majority of addicts in the world. Similarly, there are people who are dependent on medications, such as prozac for depression or narcotics for chronic pain. Now you can say the depression or chronic pain is a disease, but the drug dependency in those cases is just a side effect of the medication used to treat the disease. If using a drug on a daily basis helps a person function better, and the use is not compulsive, I don't see how it can be called a disease.

In some situations though addiction is a disease, like if someone is using compulsively or is using more than they need to and is unreasonably harming one's self or others by using that much. That might be the case with vast majority of younger people losing control with recreational use of opiates/opiods. But don't generalize it to all addiction, or even all addiction to opiates/opiods.

I disagree, and think that it is you (and others) who are 'generalising' what it means to be addicted.

This from The American Heritage Stedman's Dictionary (2nd ed., 2004):

ad.dic.tion
n.
Habitual psychological or physiological dependence on a substance or practice beyond one's voluntary control.

Of course, considering the contention within the medical community as to the precise definition of addiction, this is a little simple. For a more detailed discussion see this. But the basic point remains the same - addiction is a 'disease' in the sense that it represents some form of behaviour characterised by dependency, and excessiveness, and driven by cravings or compulsion. These characteristics are due to substantive adaptive changes in the brain. Moreover, to cease the behaviour (to stop taking the drug) effects a withdrawal that is both psychological and physical.

Ok, the point? JUST BECAUSE SOMEONE DRINKS COFFEE EVERYDAY DOES NOT MEAN THEY ARE AN ADDICT!!! I drink tea or coffee pretty much everday, but don't get actual cravings. Nor do I feel 'withdrawal' if I go without. If I abused coffeee enough I'm sure I would get those cravings. But those cravings would be a RESULT of adaptive changes in my brain that I brought about myself by abusing the drug caffeine. OK? I abuse caffeine by heaping it upon my body to such an extent that I actually create changes in myself. I can't believe we even need to be having such a discussion. I would have thought it bleedingly obvious to an intelligent person that addiction is a condition/disease of the individual, rather than something someone 'does every day.' I drink water ever day, does that make me an addict? Well, according to simple defitions of addiction, yes it does! But it's different because water is a basic physiological need. NOT one which is self-inflicted. That's where the (OBVIOUS) line lies.

FFS, you know what makes this discussion so bleedingly inappropriate for the ADD forum? It's not just that it doesn't fit the criteria set out in the forum guidelines. It's because we're getting so heated over something so minor and BASIC.

There. I thought I had the self-discipline and not get involved in all this. I guess I was wrong.

 

[gloggawogga]

People do have cravings for caffiene, and there is a well documented physical withdrawal syndrome. If you say its compulsive behaviour that marks 'addiction' then there are poeple who use coffee compulsively. There are also poeple who use opiates/opiods in a non-compulsive way, and function better in their lives with them, such as methadone users using for chronic pain who simply dose once daily. So as long as you get my point, that using itself does not make it a disease, and that even using with physical dependency doesn't make it a disease, but using compusively or without control does make it a disease, then we are in agreement.

 

[BilZ0r]

If I had to guess, he doesn't support teachers not using red pens/markers because it puts too much pressure on a student.

Lol... you got that right....

Using compusively or without control does make it a disease

I think it's using compulsively AND without control that makes it's a disease. (Although can you use compulsively with control?)

It gets complicated though when you start talking about it being a disease, I mean, is the doctor with a heroin dependency before the Harrison Narcotics act (who I would call addicted) but he doesn't have a problem, so does he have a disease? He would as soon as a heroin became illegal. Is it kinda like saying someone with asthma doesn't have a disease so long as they have access to their inhaler? *shrug*